Trospectomycin in Acute Pelvic Inflammatory Disease: A Preliminary Report

Objective: The purpose of this study was to compare the clinical efficacy and safety of intravenous trospectomycin to that of cefoxitin plus doxycycline in the treatment of women hospitalized with acute pelvic inflammatory disease (PID)

“Giant” nitrogen uptake in ionic liquids confined in carbon pores

Ionic liquids are well known for their high gas absorption capacity. It is shown that this is not a solvent constant, but can be enhanced by another factor of 10 by pore confinement, here of the ionic liquid (IL) 1-ethyl-3-methylimidazolium acetate (EmimOAc) in the pores of carbon materials. A matrix of four different carbon compounds with micro- and mesopores as well as with and without nitrogen doping is utilized to investigate the influence of the carbons structure on the nitrogen uptake in the pore-confined EmimOAc. In general, the absorption is most improved for IL in micropores and in nitrogen-doped carbon. This effect is so large that it is already seen in TGA and DSC experiments. Due to the low vapor pressure of the IL, standard volumetric sorption experiments can be used to quantify details of this effect. It is reasoned that it is the change of the molecular arrangement of the ions in the restricted space of the pores that creates additional free volume to host molecular nitrogen

A Medical Student Foray into the Depths of Public Health: An Exploratory Investigation Toward a Community Dashboard Characterizing the Experiences of Frailty in Order to Guide Improvement

While it is known that there are many shortcomings in the care of the elderly, their rate and impact on the community and the elderly themselves is not well understood. In exploring the possibilities for using existing data and available informants, a dashboard could be created that would enable a geographic community to understand the experience of living with disabilities in old age, to prioritize problems, and to test improvements. The methods included a literature review to understand what and how easily information could be accessed, gathered, and presented. In regards to literature on data collection, CMS claims data, MDS, OASIS, and death certificate follow back interviews were examined. In addition, other databases and dashboards were explored to better understand methods and aims. Interviews were then pilot-tested with caregivers of frail elders, both alive and deceased. It was ultimately concluded that by using existing data from utilization and other required data sets, a geographic community could construct a useful dashboard to prioritize and monitor improvements in elder care. The biases, which would be fairly stable across time for any one community, could be estimated. The costs could be mitigated with inexpensive access and off-the-shelf analytic packages. Most importantly, by marrying the breadth of information from large data sources with the depth of caregiver interviews, a platform could be created that motivates communities to undergo a very necessary elder care reform

Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries; results from a preterm delivery study

<p>Abstract</p> <p>Background</p> <p>Bacterial vaginosis (BV) during pregnancy is associated with an increased risk of preterm delivery but little is known about factors that could predict BV. We have analyzed if it is possible to identify a category of pregnant women that should be screened for BV, and if BV would alter the pregnancy outcome at term; we have also studied the treatment efficacy of clindamycin.</p> <p>Methods</p> <p>Prospective BV screening and treatment study of 9025 women in a geographically defined region in southeast Sweden. BV was defined as a modified Nugent score of 6 and above. Data was collected from the Swedish Medical Birth Register. Women allocated to treatment were supplied with vaginal clindamycin cream. The main outcome goals were to identify factors that could predict BV.</p> <p>Results</p> <p>Vaginal smears were consistent with BV criteria in 9.3%. Logistic regression indicates a significant correlation between smoking and BV (p < 0.001) and a greater prevalence of BV in the lower age groups (p < 0.001). We found no correlation between BV and history of preterm deliveries, previous miscarriages, extra-uterine pregnancies, infertility problems or reported history of urinary tract infections–factors that earlier have been associated with BV. Treatment with clindamycin cream showed a cure rate of 77%. Less than 1% of women with a normal vaginal smear in early pregnancy will develop BV during the pregnancy. There was no association between BV and the obstetric outcome among women who delivered at term. Women with BV, both treated patients and nontreated, had the same obstetric outcome at term as women with normal vaginal flora.</p> <p>Conclusion</p> <p>BV is more than twice as common among smokers, and there is a higher prevalence in the younger age group. However these two markers for BV do not suffice as a tool for screening, and considering the lack of other risk factors associated with BV, screening of all pregnant women might be a strategy to follow in a program intended to reduce the number of preterm births.</p

Asymptomatic microscopic hematuria in women requires separate guidelines

The guidelines recently updated by the American Urological Association for the evaluation of asymptomatic microscopic hematuria (AMH) are based on data derived predominantly from men. They cannot be reliably applied to females as the epidemiology of AMH is gender dependent. The research on women in this area has been limited. It is incumbent on the experts in the field of female pelvic medicine to advance the science and develop management algorithms for AMH in women

The effect of obesity on total abdominal hysterectomy

OBJECTIVE: To compare perioperative outcomes of total abdominal hysterectomy (TAH) between obese and nonobese women. METHODS: The medical charts of all women who underwent TAH for benign gynecological conditions at Temple University Hospital between 1997 and 2002 were reviewed. We excluded those who had concomitant surgery except for adnexal removal. The rates of perioperative indices were compared between obese (body mass index [BMI] ≥ 30 kg/m²) and nonobese women; p \u3c 0.05 was considered significant. RESULTS: Of 357 women, 172 (48.2%) were obese, and 185 (51.8%) were not. Among the baseline characteristics, only race was statistically different between the groups. There were more African American women among the obese women (82.5% vs. 70%, p \u3c 0.05). Postoperative complications, including urinary tract injury, were not significantly increased in the obese group. On the contrary, nonobese women had a significantly higher incidence of ileus (13.5% vs. 6.4%, p \u3c 0.05). Although operative time was significantly prolonged for obese women, obesity did not increase the length of hospitalization, transfusion rate, and perioperative hemoglobin change. All these results remained the same even after controlling for race. CONCLUSIONS: Contrary to the general opinion, obesity does not significantly affect the perioperative outcomes for TAH performed for benign gynecological causes